+ Site Statistics
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Koch's phenomenon after BCG vaccination and the two-step tuberculin test in elementary school children

Koch's phenomenon after BCG vaccination and the two-step tuberculin test in elementary school children

Kekkaku 73(6): 395-401

In Japan, BCG vaccination, which covers more than 90% of infants, has been given according to the national immunization policy. Moreover, first-grade children in elementary school are screened with tuberculin skin test, and those who show negative reaction in the Japanese standard, i.e. size of erythema less than 10 mm, are re-vaccinated with BCG according to the Tuberculosis Prevention Law. However, since the incidence of tuberculosis among children below age 14 is as low as 1.5/100,000 in Japan, it is time to reconsider the BCG vaccination policy. As the first step to assess the efficiency of the present program, we observed the occurrence of Koch's phenomenon after BCG vaccination in elementary school children in Chiba City in 1995 and 1996, and we introduced the two-step tuberculin test to elementary school children in 1997. Among 180 BCG vaccinated children in 1995 and 1996, 168 (93.3%) had been vaccinated by 4-year of age. We could follow local reaction of BCG re-vaccination and observed Koch's phenomenon in 117 (69.6%, 95% C.I. of 62.7-76.6%). Among 92 tuberculin negative children in 1997, 85 (92.4%) had been vaccinated by 4-year of age. In the two-step tuberculin test program of 85 initial negative-reactors, 63 (74.1%, 95% C.I. of 64.8-83.4%) turned to positive by the second test. Those results suggest that more than 69% of tuberculin-negative school children who were vaccinated previously maintained immunity with BCG. Our studies raised a problem of the current BCG re-vaccination policy that depends on the result of tuberculin test. Due to the discrepancy between tuberculin allergy and immunity in tuberculosis, many school children may be given BCG vaccination unnecessarily. Taking into consideration the incidence of tuberculosis in children, discontinuation of BCG re-vaccination policy at elementary school entrance should be considered.

(PDF emailed within 1 workday: $29.90)

Accession: 046508832

Download citation: RISBibTeXText

PMID: 9695482

Related references

BCG-vaccination, tuberculin allergy and tuberculosis in school children; a follow-up study from Stockholm's elementary schools, 1945-51, with special regard to social factors. Acta Paediatrica. Supplementum 44(Suppl 101): 1-128, 1955

Tuberculin test in infants and school children with reference to BCG vaccination. Praxis der Pneumologie 22(11): 705-708, 1968

Comparative sensitivity to Koch's old tuberculin in Pirquet's test and to purified tuberculin in standard dilutions in the Mantoux test at 1, 2 and 5 T.O. in children and adolescents. Pediatriia Akusherstvo i Ginekologiia 1972(2): 15-16, 1972

Developing and Validating a Step Test of Aerobic Fitness among Elementary School Children. PhysioTherapy Canada. Physiotherapie Canada 71(2): 187-194, 2019

Improvement of tuberculin test results with BCG vaccination in set-city primary school children from 2000 to 2002. Japanese Journal of Public Health 51(2): 103-108, 2004

Effects of diving reflex test master two step test swimming and diving on electrocardiogram in elementary school children. Memoirs of Osaka Kyoiku University Series III Natural Science & Applied Science 40(1): 81-87, 1991

Tuberculin skin test results and the booster phenomenon in two-step tuberculin skin testing in hemodialysis patients. Renal Failure 27(4): 425-428, 2005

Tuberculin and chest x-ray investigations among the school children of the children's homes and the elementary schools. Archivio di Tisiologia E Delle Malattie Dell'apparato Respiratorio 16: 677-682, 1961

Two-step tuberculin skin test and booster phenomenon prevalence among Brazilian medical students. International Journal of Tuberculosis and Lung Disease 12(12): 1407-1413, 2008

Percutaneous reactions to tuberculin in elementary school children at Vigevano. Bollettino Dell'istituto Sieroterapico Milanese 31(3-4): 143-147, 1952

Selective tuberculin tests and repeated BCG vaccination in school children in school years 1951-52 and 1952-53. Orvosi Hetilap 95(1): 17-21, 1954

Positive tuberculin reactions among American elementary school children in Europe. Military Medicine 147(3): 197-199, 1982

Diagnosis of tuberculosis in school children. On the significance of value of school health tuberculin diagnosis in high BCG vaccination register of school youth. Das Offentliche Gesundheitswesen 29(2): 88-96, 1967

Results of preliminary research in the tuberculin reaction in elementary school children in Florence. Lotta Contro la Tubercolosi 20(11-12): 896-903, 1950

Value of tuberculin-x-ray survey in school children; research conducted in Novara elementary schools. Lotta Contro la Tubercolosi 20(9-10): 785-792, 1950